Prevention Flashcards
What are the three strategies of preventative medicine?
Primary, secondary, and tertiary prevention levels
What is primary prevention?
Primary prevention is a strategy in which intervention occurs BEFORE health effects occur
What are some examples of primary prevention?
Vaccines, altering risky behaviors (tobacco use), banning substances known to be associated with a disease or health condition, education, wearing sun screen, using seat belts, washing hands
What is the goal of primary prevention?
Aims to prevent the disease from occurring, thus reducing both incidence and prevalence of disease
What is secondary prevention?
Screening to identify diseases in the earliest stages, before the onset of signs and symptoms
What are some examples of secondary prevention?
Screening tests, mammography, regular blood pressure testing, checking suspicious skin growths, modifications of work situations
When are secondary prevention measures used?
Used after the disease has occurred but before the person has an idea that something is wrong
What are the two goals of secondary prevention?
Find the disease and treat it early with the hope that it can be cured, thus decreasing morbidity associated with disease
Prevent the spread of transmittable diseases
What is tertiary prevention?
Managing disease post diagnosis to slow or stop disease progression
What are some examples of tertiary prevention?
Chemotherapy, rehabilitation, screening for complications, patient support groups, chronic pain management programs, stroke rehab programs, screening for renal issues in diabetics
Tertiary prevention is aimed at who?
Aimed at the person who already has the disease
What are the three goals of tertiary prevention?
Prevent damage and pain from disease and help with management
Slow disease progression
Address and possibly prevent potential complications associated with disease
What are the target activities of tertiary prevention?
Improve the care to patients with the disease and cure the disease so that patients are able to continue with their normal lives
Nutrition counseling to a group of well individuals is an example of what level of disease prevention?
Primary
The nurse starts a support group for the families of individuals with Parkinson’s Disease. This would be what level of disease prevention?
Tertiary
Explanation: helps family with managing patient
Which is the following is NOT an example of primary prevention?
- Treatment of STI
- Safety education
- Prevention of the initial occurrence of disease
- Education about health and safety habits
Treatment of STI
Which of the following is NOT an example of secondary prevention?
- Regular exams and screening tests to detect disease in its earliest stages
- Daily, low-dose aspirins and/or diet and exercise programs to prevent further heart attacks or strokes
- Immunization against infectious diseases
- Suitably modified work so injured or ill workers can return safely to their jobs
Immunization against infectious diseases
What is the USPSTF and what do they do?
United States Prevention Services Task Force - organization that provides recommendations for preventative services
What are the 5 grades of the USPSTF’s prevention recommendations?
A, B, C, D, and I
What is USPSTF’s grade A?
The USPSTF recommends the services and there is a high certainty that the net benefit is substantial. The service should be offered of provided.
What is the USPSTF’s grade B?
The USPSTF recommends the service. There is a high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial. The service should be offered or provided.
What is the USPSTF’s grade C?
The USPSTF recommends selectively offering or providing this service to individual patient based on professional judgment and patient preferences. There is at least moderate certainty that the net benefit is small. The service should be offered or provided for selected patients depending on individual circumstances.
What is the USPSTF’s grade D?
The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits. The service should be discouraged.
What is the USPSTF’s grade I?
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined. If the service is offered, patients should understand the uncertainty about the balance of benefits and harms.
What is the natural history of disease?
Progression of disease in an individual over time
What are the steps of disease?
Stage of susceptibility, exposure, stage of subclinical disease, pathologic changes, onset of symptoms, stage of clinical disease, time of diagnosis, stage of recovery/disability/death
What stage of disease should primary prevention be used in?
Stage of susceptibility
What stage should secondary prevention be used in?
Stage of subclinical disease
What stage should tertiary prevention be used in?
Stage of clinical disease
COVID - Primary Prevention
What is the target population?
Everyone of all ages
COVID - Primary Prevention
What is the goal?
Reduce the number of cases of COVID
COVID - Primary Prevention
What is the rationale?
Reduce exposures
COVID - Primary Prevention
Interventions at the individual level
Hand washing, physical distancing, wearing a mask, vaccinate, avoid others
COVID - Primary Prevention
Interventions at the community level
Provide access to vaccines, educate public through PSAs, prepare plans for outbreak
COVID - Secondary Prevention
What is the target propulation?
Everyone who has been exposed to the virus
COVID - Secondary Prevention
What is the goal?
Reduce the number and severity of cases
COVID - Secondary Prevention
What is the rationale?
Early isolation and treatment to reduce the severity of disease
COVID - Secondary Prevention
Interventions at the individual level
Get tested if symptoms appear, quarantine, mask wearing, receive treatment
COVID - Secondary Prevention
Interventions at the community level
Travel restrictions, quarantine measures, enforce sick leave at work, send sick kids home from school, screening
COVID - Tertiary Prevention
What is the target population?
Everyone who has COVID
COVID - Tertiary Prevention
What is the goal?
Reduce number and severity of COVID-related complications and deaths
COVID - Tertiary Prevention
What are the actions?
Provide supportive care and early treatment of complications, rehab to increase recovery of normal lifestyle
COVID - Tertiary Prevention
Interventions at the individual level
Isolation/follow quarantine guidelines, seek healthcare and follow recommendations
COVID - Tertiary Prevention
Interventions at the community level
Increase healthcare capacity, ensure access to treatment, protect employees who are out sick from losing jobs, research to find better treatments
What is prevalence?
The proportion of cases in the population at a given time (all cases / population at risk)
What information does prevalence provide?
How widespread disease is
What is incidence?
The rate of occurrence of new cases
What information does incidence provide?
The risk of contracting a disease
What is morbidity?
Term used in public health referring to sickness
What is morbidity rate?
Incidence of a particular disease in a specific location
What is mortality?
Term used in public health referring to death
What is a non-modifiable risk factor?
Risk factors that can not be changed
What are some examples of non-modifiable risk factors?
Age, gender, race, ethnicity, family history
What is a modifiable risk factor?
Risk factors that can be changed and arise as a result of unhealthy lifestyle choices
What are some examples of modifiable risk factors?
Alcohol, smoking, inactivity, stress, high blood cholesterol
Order the most preventable causes of death based on the most deaths per year to the least.
Tobacco smoking, obesity, alcohol, infectious diseases, toxins, motor vehicle collisions, firearm deaths, STIs, drug abuse
What is the leading reason for preventable causes of death?
Bad lifestyle choices
What are the five lifestyle changes used to improve health?
Avoid all tobacco usage in any form, avoid alcohol or use in moderation, maintain a healthy weight, exercise regularly, eat a healthy diet
T/F? Tobacco control programs have shown to reduce smoking rates, associated death and diseases.
True
Tobacco control programs include what efforts?
Establish smoke-free policies, reduce the social acceptance of tobacco use, promote cessation, help tobacco users quit, prevent initiation of tobacco use
What are the approaches to implementing efforts of tobacco control programs?
Education, clinical strategies, regulatory strategies, social strategies
What are three methods used to quit smoking?
Brief clinical intervention, counseling, nicotine replacement products (OTC or prescription)
What are the health benefits of quitting smoking?
Escape nicotine dependence and eliminate exposure to carcinogens
T/F? There are no health benefits of quitting smoking after someone has smoked for a long period of time.
False. Benefits are greater for people who stop at earlier ages BUT cessation is always beneficial
E-cigarettes and vaping are the most common in what populations?
Current smokers, former smokers, youth (more popular in high school)
As cigarette usage ______, vaping usage _____.
As cigarette usage DECREASES, vaping usage INCREASES.
What are the specific health risks for youth who use nicotine?
Nicotine exposure in adolescents (who are still developing) can change how the brain works - leading to a lifetime addiction, mood disorders, lowering of impulse control
What is “The Real Cost?”
A campaign launched by the FDA to prevent youth E-cigarette usage through education
What adult BMI indicates a patient being overweight?
25-29.9
What adult BMI indicates a patient being obese?
30+
What adult BMI indicates a patient being extremely obese?
40+
Besides BMI, how is body fat composition measured?
Skin-fold thickness and waist circumference
What three things contribute to obesity?
Caloric balance, environment, and genetics
What are the major health risks associated with obesity?
Diabetes, heart disease, GERD, high BP, cancer, sleep apnea
What is the goal of obesity treatment?
Reach and stay at a healthy weight
What are some treatment methods for obesity treatment?
Dietary changes, exercise and activity (at least 150 minutes a week), behavioral changes (counseling, support groups), prescription weight loss medication (to be used in conjunction with other methods), weight-loss surgery
What is the goal of bariatric surgery?
Limit the amount of food a patient is able to comfortably eat
When does bariatric surgery become a consideration for patients?
Obesity (BMI 35-40+) and another serious weight-related health issue
Bariatric surgery allows for the most dramatic weight loss of up to ____% of excess body weight
50+
What are the signs for children who are overweight?
BMI between 85th and 95th percentile for children of the same sex and age
What are the signs for children who are obese?
BMI above 95th percentile for children of the same sex and age
What factors influence childhood obesity?
Racial/ethnic group, household income, educational level of the head of household
Alcohol abuse puts individuals at a higher risk for what conditions?
HTN, GI bleeding, sleep disorders, major depression, cirrhosis of the liver, stroke, cancer
What is considered an elevated alcohol consumption for men?
5+ standard drinks in a day or 14+ a week
What is considered an elevated alcohol consumption for women?
3+ standard drinks in a day or 7+ a week
What is alcohol abuse?
Individual misuses alcohol but the patient does not have withdrawal symptoms OR individual needs more and more alcohol to get intoxicated
What is alcoholism?
Individual misuses alcohol and a lack of alcohol leads to withdrawal AND more is always needed to reach a satisfactory level of intoxication
What are risk factors for alcoholism?
Mood/mental problems, parents with an alcohol problem, low self-esteem, feeling out of place, social factors, age, sex
T/F? Children and teens who have their first drink of alcohol between ages 10 and 12 are more at risk for developing a drinking problem.
False. Children and teens who have their first drink of alcohol between ages 11 and 14 are more at risk for developing a drinking problem
Are men or women more likely to become dependent on alcohol?
Men
What are the five signs/symptoms of alcohol problems?
- Repeatedly neglecting your responsibilities at home, work, or school
- Using alcohol in situations where it’s physically dangerous
- Experiencing repeated legal problems on account of your drinking
- Continuing to drink even though alcohol use is causing problems in relationships
- Drinking as a way to relax or de-stress
What is CAGE?
The CAGE can identify alcohol problems over the lifetime. Two positive responses are considered a positive test and indicate further assessment.
What do the letters of CAGE stand for?
C - cut down (Have you ever felt you should cut down on your drinking?)
A - annoyed (Have people annoyed you by criticizing your drinking?)
G - guilty (Have you ever felt bad or guilty about your drinking?)
E - eye opener (Have you ever had a drink first thing in the morning to steady your nerves of get rid of a hangover?)
What are the treatment options for alcoholism?
Detoxification, learning skills (group therapy), alcohol education, counseling, address problems in daily life, medication
What role does medication play in alcoholism treatment?
Play more of an adjunct role and is generally aimed at making even the smallest consumption of alcohol an unpleasant experience
What are the seven tips to reduce your risk for cancer?
- Don’t smoke
- Eat a healthy diet
- Maintain healthy weight and include physical activity
- Protect yourself from the sun
- Get immunized
- Avoid risky behavior (ei. safe sex)
- Practice early detection
What are the risk factors for colorectal cancer?
Over 50 years of age, genetic mutation, family history, physical inactivity, obesity, smoking and heavy alcohol use, diet high in red/processed meat, racial and ethnic background (African Americans have highest incidence but we don’t know why)
When should screening for colorectal cancer start?
Age 45
What are the screening methods of colorectal screening?
Fecal occult blood test once a year
Flexible sigmoidoscopy every five years
CT colonography every five years
Colonoscopy every ten years
What are the risk factors of lung cancer?
Smoking/secondhand smoke
Toxins at home or work
Family history of lung cancer
What are the symptoms of lung cancer?
Cough that does not go away
Wheezing
Blood or rust-colored sputum
Chest pain
Shortness of breath
Weight loss/loss of appetite
What are screening measures of lung cancer?
Chest x-ray, sputum cytology, low-dose spiral CT scan
Who should undergo low-dose spiral CT scans (LDCT scan) as a screening recommendation?
Adults aged 50-80 who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years
What are the risk factors for bladder cancer?
Smoking
Gender (3x more common in men)
Occupation (working with dye, rubber, leather print, paint)
Exposure to arsenic in drinking water
Chronic bladder condition
What are the screening measures for bladder cancer?
Hematuria test
Urine cytology
Cystoscopy
Biopsy
T/F? Current evidence is insufficient to recommend bladder cancer screening.
True
What are the risk factors of skin cancer?
Lighter natural skin
Family history
Exposure to sun
History of early-life sunburns
History of indoor tanning
Skin that responds abnormally to the sun
Blond or red hair
Certain types/number of moles
What measures can be taken to reduce the risk of developing skin cancer?
Avoid prolonged exposure to UV rays
Stay in the shade
Monitor children’s sun exposure
Avoid sunburns
Wear protective clothing
Wear sunscreen of SPF 15 or higher (reapply!)
What does the ABCDE system measure?
Self examination tool for skin lesions and moles
What does ABCDE stand for?
A - asymmetry
B - border
C - color
D - diameter
E - evolving
What ABCDE screening would be consistent with a melanoma?
A - asymmetrical
B - uneven borders
C - Variety of colors
D - large in diameter
E - changes in mole
What state has the highest rate of people not insured?
Texas
T/F? Non-citizens are more likely to be uninsured
True
What is the leading cause of why people are uninsured?
Tried to get coverage but it was too expensive
T/F? Lack of insurance is a signifiant obstacle to actually receiving healthcare.
True
T/F? The healthcare provided to the uninsured is equitable to the care provided to those with insurance.
False
T/F? Most people who are uninsured are unemployed.
False
What are some of the core safety net providers for people without insurance?
Community health centers, public hospitals, local health departments, emergency department, private clinics
What is the goal of Healthy People 2020?
Promote quality of life, healthy development, and healthy behaviors across all life stages
What is the role of the Office of Disease Prevention and Health Promotion (ODPHP)?
Develops and coordinates a wide range of national disease prevention and health promotion activities
What is the U.S. Preventative Services Task Force (USPSTF)?
Conducts scientific evidence reviews of a broad range of clinical preventative health care services and develops recommendations
What is the Michigan Newborn screening program?
Aims at finding babies with rare but serious disorders that require early treatment
What is the National Institute of Alcohol Abuse and Alcoholism (NIAAA)?
Provides leadership in national effort to reduce alcohol-related problems
